In vertebral compression fractures, the potential of kyphoplasty for restoring vertebral height is limited by the loss of restored height that occurs when the balloon is deflated and removed. SpineJack ® is also inserted percutaneously but is then left within the vertebral body after its expansion to reduce the fracture, thus avoiding loss of correction before the injection of cement. SpineJack ® was used in 77 patients to treat 83 recent VCFs (55.4% at L1–L2) due to trauma (59.7%) or osteoporosis (40.3%). Three (3.9%) complications were recorded, but none was related to SpineJack ® : there was one case each of symptomatic cement leakage along a secondary pedicular fracture line; infection; and incipient device migration at the beginning of the learning curve. The rate of adjacent fractures was only 2.6%. The 5-year outcomes demonstrate that SpineJack ® provides both immediate and long-term benefits in terms of pain relief, functional recovery, and maintenance of vertebral height restoration.